Individual
DR. CLINT T TAYLOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
1684 FALCON AVE, CARMI, IL 62821-1370
(618) 382-4683
(618) 382-4684
Mailing address
1684 FALCON AVE, CARMI, IL 62821-1370
(618) 382-4683
(618) 382-4684
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
046-009761
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
203086173-62821-01
—
IL
Enumeration date
06/15/2006
Last updated
10/18/2023
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